Hand infection in diabetic patients.

The diabetic hand infection is less reported in the literature. Therefore, it is easily ignored and underestimated resulting in increased morbidity among the diabetic population. Diabetic hand is a rapid in progression, extensive and severe tissue destruction. We analyze the clinical course and outcome of hand infection in diabetic patients. We reviewed all the admissions with hand infection from January 2006-April 2010. Thirty-seven patients were found with associated diabetes mellitus. The demographic data, culture report, number of operations and management, hospital stay and outcome-like amputation were recorded. The average age was 62 years. Pain and swelling were the chief complaints. The cause of infection was varied. The infection was superficial in 13 and deep in 24 patients. Forty-one percent of culture report revealed polymicrobial organism. The increased length of hospital stay, reoperations and amputation were associated with deep infection and polymicrobial organism. Prompt medical and surgical attentions are the most important factors. A proper glycemic control, elevation of the affected extremity, thorough and adequate surgical debridement and appropriate antibiotics are the important considerations when dealing with diabetic hand infection.

Our early experience in surgical and clinical outcome on endoscopic cubital tunnel release: a preliminary result.

Cubital tunnel syndrome is one of the common upper extremity problem encountered. A mild syndrome can be often treated without surgery, but a failure of conservative treatment with constant symptoms or muscle atrophy and weakness requires surgical intervention. Despite the fact that is the second most common nerve entrapment in the upper limb, there is no accepted gold standard in the surgical management. But with the new technique in minimally invasive surgery and available endoscope, it addresses all potential compression sites with good visualisation but with small surgical exposure. The procedure is safe and reliable way to address this problem.

Heterotopic ossification in the middle finger: a case report.

A case of heterotopic ossification developed after traumatic laceration of the middle finger. It is extremely rare for heterotopic ossification to locate in the finger. The diagnosis was accomplished with plain radiographs as well as with MRI and confirmatory study with histopathological microscopic examination which demonstrated nubbin of bone surrounded by fibrovascular connective tissue, and the marrow was predominantly fatty with prominent ectatic vessels and patchy mild lymphocytic infiltrate and gross appearance of partly calcified bony tissue.